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HGNI: Geriatric Mental Health Series - "Back to the A-B-C's" Understanding & Responding to Behavioral Symptoms in Dementia

HGNI: Geriatric Mental Health Series - "Back to the A-B-C's" Understanding & Responding to Behavioral Symptoms in Dementia

University of Iowa College of Nursing
Hartford Geriatric Nursing Initiative (HGNI)
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Behavioral and psychological symptoms of dementia are often puzzling, and sometimes are troubling to staff, other residents and family members alike. Compassionate and effective care relies on understanding the problem from the perspective of the person with dementia and accurately assessing a diverse array of factors that may cause or contribute to behavioral symptoms. In this module, the Antecedent-Behavior-Consequence (ABC) model is applied to the care of persons with dementia. By assessing and changing common antecedents (triggers) and consequences (reactions), caregivers are often able to promote comfort and function for individuals with dementia.

This is the sixth module in the Geriatric Mental Health Training Series (GMHTS), a six-part training program designed to be taught as a one-hour educational program for care providers in long-term care settings. The six core topics address common problems faced in LTC settings. Each is designed to help staff be more knowledgeable about the causes of "problem behaviors" and about techniques to manage those troubling behaviors. The care providers' own feelings and behaviors in response to problem behaviors is examined, including the role of values and beliefs, personal needs, and stress in the work place.  All modules can be found at:

Educational objectives: 


  1. Compare and contrast key aspects of the “old” and “new” dementia care cultures (i.e., attitudes, labels, focus of care and interventions).
  2. Explain why “prevention is the best medicine” in dementia care.
  3. Define the main components of the A-B-C approach to care.
  4. Give an example of common antecedents or “triggers” in dementia care.
  5. Give an example of common automatic reactions in dementia care,
  6. Describe the relationship between behavioral symptoms, antecedents/triggers and consequences/reactions.
  7. Develop a plan of care for a person with dementia using the A-B-C approach.
  8. List crisis intervention techniques that may be used to calm and redirect a person who is intensely upset and threatened.
Additional information/Special implementation requirements or guidelines: 

The training materials were designed to be flexible, and strongly encouraged individual trainers to adapt the modules to meet their unique needs and audiences. Throughout the training materials, trainers are urged to personalize the materials by using real-life examples from their facility, try out suggested interventions with residents prior to training staff, and use as many meaningful examples as possible to help staff apply the program concepts in their day-to-day practice.

The Geriatric Mental Health Training Series (GMHTS) was developed and evaluated between 1989 and 1994 with funds from the Division of Nursing, Bureau of Health Professions, Department of Health and Human Services, under the leadership of Kathleen C. Buckwalter, PhD, RN, FAAN, Principal Investigator and current Co-Director of the Iowa HCGNE and Marianne Smith, MS, ARNP, pre-doctoral scholar of the Iowa HCGNE. This highly acclaimed training program is provided in a revised and updated format under the leadership of the HCGNE. Training materials are adapted for broad dissemination and use, and provided at no cost to users.

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Estimated time to complete: 
1 hour 30 minutes
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Suggested Citation:
HGNI: Geriatric Mental Health Series - "Back to the A-B-C's" Understanding & Responding to Behavioral Symptoms in Dementia. POGOe - Portal of Geriatrics Online Education; 2011 Available from: